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Raja MilesRM
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Raja Miles

@rajamiles

I resolve Medicare, claims, billing, and coverage questions for members, providers, and pharmacies.

United States
Message

I support health plan members with enrollment, eligibility, benefits, billing, claims, and coverage questions. At Foundever / Sitel, I manage approximately 60–80 member contacts per day while researching discrepancies and coordinating resolutions with providers and internal teams.

Previously at Elevance Health, I supported Medicare members with medical and pharmacy claims, prior authorization inquiries, grievances, and appeals. I document work in HIPAA-compliant systems including Salesforce, Zendesk, CareTend, and Unity, and explain complex next steps with empathy.

Experience

Work history, roles, and key accomplishments

HA

Billing Specialist / Customer Service Representative

Harris County Toll Road Authority

Nov 2019 - Sep 2021 (1 year 10 months)

Researched account and billing discrepancies, explained charges, processed adjustments, and resolved customer issues while maintaining accurate documentation. Worked across departments to verify information and resolve variances, and served as a trainer for billing software and procedures.

TN

Payment Processing Specialist / Customer Service Representative

The Reserves Network

Mar 2018 - Nov 2019 (1 year 8 months)

Processed high-volume payments and account transactions with accuracy and attention to detail. Researched payment disputes, invoices, balances, and transaction history while maintaining organized records and following established procedures.

Education

Degrees, certifications, and relevant coursework

HS

High School

High School Diploma, General Studies

Completed high school education.

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